First Aid: CPR

Cardiopulmonary
resuscitation, or CPR, is a lifesaving technique. It aims to keep blood and
oxygen flowing through the body when a person’s heartbeat and breathing have
stopped. It can be performed by any
trained person. It involves external chest compressions and rescue breathing.

CPR
performed within the first six minutes of the heart stopping can keep someone
alive until medical help arrives.

Although
rescue breathing techniques were used to revive drowning victims as early as
the 18th century, it wasn’t until 1960 that external
cardiac massage was proven to be an effective revival technique. The American
Heart Association then developed a formal CPR program.

While
there is no substitute for formal CPR training taught by certified instructors,
the American Heart Association has recently recommended that persons who have
not received CPR training initiate “hands only” CPR (without rescue breathing).
This method is easy to perform, is proven to save lives, and is better than
waiting until trained help arrives.

Steps for Hands-Only CPR

Survey the Scene

Make
sure it’s safe for you to reach the victim.

Check
the Person for Responsiveness

Shake
the shoulder and ask loudly, “Are you OK?” For an infant, tap the bottom of the
foot and check for a reaction.

If
the Person Is Not Responsive, Call 911

Or ask someone else
to call. If you’re alone and believe the person is a victim of drowning, or if
the victim is a child, begin CPR first, perform for two minutes, and then call
911.

Check
the Heart with an AED

If an automated external
defibrillator (AED)
is readily available, use this
device to check the victim’s heart rhythm and—if the machine instructs—deliver one
electric shock to the victim’s heart before beginning chest compressions. If
the victim is a child ages 1 to 8, perform CPR first for two minutes before
checking the heart with an AED. Also, use the device’s pediatric pads if they
are available. An AED’s usefulness in infants under one year of age is not
conclusive or strongly recommended.

If an AED is not immediately
available, do not waste precious seconds or moments looking for the device.
Start chest compressions immediately.

Locate
Hand Position

For adults, place the
heel of one hand in the center of the person’s chest, between the nipples. Put
the other hand on top of the first hand and interlock your fingers so they are
drawn up and the heel of the hand remains on the chest. For children ages one
to eight, use just one hand in the center of the chest, between the nipples.
For infants, place two fingers in the center of the chest, slightly below the
nipple line.

Begin
Compressions

For an adult, use
your upper body to push straight down on the chest at least 2 inches, and at a
rate of 100 compressions per minute. Allow the chest to recoil between
compressions. For ages 1 to 8, push straight down on the chest about 2 inches
at a rate of 100 compressions per minute, and allow the chest to recoil between
compressions. For an infant, push straight down on the chest 1½ inches at a rate of 100
compressions per minute, and again let the chest recoil between compressions.

Continue
Compressions

Repeat the
compression cycle until the victim starts to breathe, or medical help arrives.
If the person begins to breathe, have them lie on their side quietly until
medical help arrives.

Steps for Mouth-to-Mouth Resuscitation

In 2010, the American
Heart Association revised its CPR guidelines, announcing that chest
compressions should be performed first, before opening the victim’s airway. The
new acronym C-A-B (Compressions-Airway-Breathing) now replaces the old A-B-C
(Airway-Breathing-Compressions) model.

In the first few
minutes of cardiac arrest, there is still oxygen in the victim’s lungs and
bloodstream. Therefore, starting chest compressions first (on an individual who
is unresponsive or not breathing normally) can help send this critical oxygen
to the brain and heart without any delay.

If you’re trained in
CPR and come across an individual who is unresponsive or having difficulty
breathing, follow the steps for Hands-Only CPR for 30 chest compressions.

Then perform the
following actions:

Open
the Airway

Put the palm of your
hand on the person’s forehead, and tilt the head back. Gently lift the chin
forward with the other hand. For small children and infants, a head tilt alone
will often open the airway.

Give
Rescue Breaths

This is appropriate
for ages one through adulthood. With the airway open, pinch the nostrils shut,
and cover the person’s mouth with a CPR face mask to make a seal. For infants,
cover both mouth and nose with the mask. If a mask is not available, cover the
person’s mouth with yours. Then give two rescue breaths, each lasting about one
second. Watch for the chest to rise with each breath. If it does not rise,
reposition the face mask and try again.

Alternate
Rescue Breathing with Chest Compressions

Continue CPR,
alternating 30 compressions with two rescue breaths, until the person begins to
breathe or until medical help arrives. If the person begins to breathe, have
him or her lie on their side quietly until medical assistance is on the scene..

CPR and AED Training

The American Red
Cross and the American Heart Association (AHA), as well as other agencies,
offer CPR training as well as training in the use of an automated external
defibrillator (AED).

The AED is a device
that can detect abnormalities in a patient’s heart rhythm and, if needed,
deliver an electric shock to the chest (defibrillation) to restore normal
rhythm to the heart. According to the AHA, most sudden cardiac arrests are
caused by a fast and irregular heart rhythm that begins in the heart’s lower
chambers, or ventricles. This is called ventricular fibrillation. An AED can
help restore the heart’s normal rhythm and even help revive a person whose
heart has stopped functioning.

With training, an AED
is easy to use. In conjunction with CPR, the device (when used properly)
greatly increases a victim’s chances for survival.